Physician resources

Global Medicine

Many students go into medicine driven by a desire to make a difference. With global medicine, they can impact the most impoverished communities in the world.

In this series on international health work, StudentDoc speaks with a variety of medical workers to get a better understanding of what leads physicians to pursue global medicine and international care, venturing beyond U.S. cities and rural communities to remote villages in Africa, South America, and elsewhere.

"As a fourth-year medical student on my primary care rotation on the Navajo Reservation in Arizona, I knew that I wanted to practice medicine in an underserved community," explains Dr. Lisa V. Adams, the editor, with Laurel A. Spielberg, of Africa: A Practical Guide for Global Health Workers.

"I also found myself drawn to the complexity of working in a cross-cultural setting. With a strong desire to immerse myself in understanding my patients’ culture (as much as an outsider can), I felt I was well suited for international work."

Dr. Adams went on to become the coordinator of the Global Health Initiative at Dartmouth's Dickey Center for International Understanding. She also serves as an Assistant Professor at Dartmouth Medical School, teaching courses such as Global Health and Society and the Introduction to Global Health offered to both undergraduate and medical students. But what drew her into international health work was very personal.

"My first overseas experience was working in my family’s homeland of Albania shortly after the fall of the Communist regime. During those six weeks, I was introduced to public health and also learned I had a strong interest in understanding health systems. And for many of us who choose this work, there is the satisfaction of being able to contribute in a setting where the needs are staggering and the circumstances compelling."

For Love of the Work

"I also like working with my international colleagues from whom I learn so much. The most durable collaborations have been built on mutual respect and sharing of experience. I know there are some physicians who explore global health work because of the exotic nature and opportunity to travel – but if there is not a love of the work, an appreciation of the host culture and a certain amount of humility, they (fortunately) tend not to stay in the field."

In Dr. Adams' Africa: A Practical Guide, she address humanitarianism, globalism, and human rights issues, concepts many physicians and medical students considering international work have already tuned into.

"Most of the physicians I know engaging in global health work have a strong interest in these topics and therefore have taken it upon themselves to self-educate on these issues. By nature, most of the physicians looking to push themselves outside of their comfort zone and take on the challenges involved with global health work are, to at least some degree, highly motivated and self-starters."

Doing Homework for International Work

But before becoming immersed in the day-to-day efforts to provide medical care in high-need areas such as Ghana or Tanzania in Africa, Peru or Bolivia in South America, international health workers must immerse themselves in the study of those cultures.

"Many understand that health crises are complex, and the reasons behind them are multiple, and that they cannot be treating patients and their illnesses in a vacuum – that is true everywhere but particularly when there are important social, cultural, and political overlays to the health and disease concerns of a population."

This involves reading as much as possible about these cultures but also engaging with communities connected to them as well. Medical schools often offer courses that emphasize international health issues, such as the global health classes Dr. Adams teaches at Dartmouth.

"Young physicians about to embark on a first global health assignment often have experienced mentors or supporting organizations that will ensure the physicians gains some understanding of the context in which they will be working. We begin emphasizing the understanding of globalism and human rights issues with our undergraduate and medical students who work on our global health programs by providing them a comprehensive orientation process about the culture, history, and political situation where they will be working."

"With the ease of accessing information these days," Dr. Adams continues, "there is no reason not to be fully educated on these issues before departing. And I can guarantee you, if someone thought these issues were not critical to their global health work, they would be convinced otherwise after their first overseas placement."